Practicing, Preaching, and Psychological Safety

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Practice what you preach and preach what you practice. But what does this mean in terms of ensuring psychological safety when you use experientials in therapy? It means inviting clients to undergo only those experientials you have tried upon yourself and can cite the indications/contraindications of for use with others. If you’ve attended a workshop in which you learned about a particular method or material, you’ve gained knowledge and skills in applying that method or material with the population(s) and at the stage(s) of treatment that were covered in the workshop. The most horrible act of disregard for this principle that I’ve had the misfortune of witnessing, at the nudging of a hospital exec who thought something might be fishy, was committed by a non-art therapist who’d attended a conference that celebrated the link between artistic pursuits and mental illness. She had made a body tracing in one of the workshops there and liked it so much that she went back to her job at a cancer center and put together an “art therapy” support group despite her lack of formal training in art therapy and her lack of familiarity with art materials (she brought along a former art teacher to help group participants work with the materials because she didn’t feel competent in this area). Can you guess where this train wreck was headed?

Sure enough, in the very first session of this support group, she asked the members to undergo body tracings and then use the art materials to depict their body’s cancer journey. Hmm…using body tracings to celebrate the connection between artistic endeavors and mental illness is not the equivalent of using body tracings with cancer patients. And there’s a big difference between the level of psychological safety in a workshop of people who specifically signed up for a body tracing experience vs. the level of psychological safety in the first session of a support group whose members have physically been invaded by illness, intruded upon by the medical community, and ambushed by a surprise body tracing experience. Needless to say, the session was a flop and the group folded within a matter of weeks. (As an aside, I would suggest that non-art therapists refrain from doing body tracings with their clients. How you would defend your qualifications to use this method if a client accused you of anything? Eek.)

Ensuring the psychological safety of art methods is one thing, but ensuring the psychological safety of art materials can be a harder thing for non-art therapists to grasp. Without going into a semester’s worth of lectures on the subject, let me just say that people who are emotionally dysregulated due to mental illness, head injury, and/or trauma are likely to have a different kinesthetic/sensory experience of art materials than are people who are emotionally intact. Thus, these individuals can actually be regressed or retraumatized through the use of some materials. It takes specialized training to learn the ins and outs of titrating emotional tolerance and facilitating affect regulation via the use of art materials. In the absence of such training, clinicians and their clients are better off using materials that support the cognitive control of affectively charged content and provide reflective distance from it. These two qualities also define the essence of verbal therapy, so materials in this category lend themselves handsomely to verbal therapy processes. Examples of such materials include beads, markers, and fabric scraps. In order to determine whether a material falls into this category, a tripartite rule to remember is that if a material is resistive to the exertion of pressure (meaning that its form is not altered; ex: beads), easy to manage when exerting pressure (meaning that it doesn’t create unintended forms; ex: markers), or demonstrates resilience after pressure has been exerted (meaning that it bounces back to its original form; ex: fabric scraps), it’s unlikely that the material will contribute to regression and retraumatization.

Practicing what you preach and strengthening your awareness of how psychological safety is affected by art methods and materials will in turn strengthen your ability to preach what you practice. So practice, preach, and be safe!

With appreciation for the important work you do,

Megan November 2011

About the Image on This Page

This is a thumbnail of Public Domain Abstract Art, posted to The Public Domain website by Mitch Featherston in 2012. Click here for more information.

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Disclaimer

Art therapy is a regulated mental health profession; standards of competent art therapy practice in the U.S. require a graduate education in art therapy as well as supervised post-graduate training in art therapy. The information presented on this site is not intended to serve as a substitute for these requirements, but it may enhance the reader's understanding of the use of art in assessment and treatment.